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2 Presentation graphics summarizing the key points related to this topic are now available on ReproLine at Trainers can download these graphics and use them as overhead transparencies when conducting courses and workshops. The graphics can also be viewed and downloaded from the ReproLine CD-ROM. To obtain a copy of the CD-ROM, please contact: Natalie Maier Phone: Fax: JHPIEGO, an affiliate of the Johns Hopkins University, is a nonprofit corporation dedicated to improving the health of women and families throughout the world. TRADEMARKS: All brand and product names are trademarks or registered trademarks of their respective companies. Norplant is the registered trademark of The Population Council for subdermal levonorgestrel implants. Financial support was provided by the Office of Population, Center for Population, Health and Nutrition/Global Programs, Field Support and Research Bureau/CMT Division, United States Agency for International Development, under the terms of Award No. HRN-A The opinions expressed herein are those of JHPIEGO and do not necessarily reflect the views of the United States Agency for International Development. JHPIEGO Corporation October 1997

5 OVERVIEW BEFORE STARTING THIS TRAINING COURSE This instructional design skills course will be conducted in a way that is very different from traditional training courses. First of all, it is based on the assumption that people participate in courses because they:! Are interested in the topic! Wish to improve their knowledge and skills, and thus their job performance! Desire to be actively involved in course activities For these reasons, all of the course materials focus on the participant. For example, the course content and activities are intended to promote learning, and the participant is expected to be actively involved in all aspects of that learning. Second, in this type of learning program, the trainer and the participant are provided with a similar set of educational materials. The trainer by virtue of her/his previous training and experiences works with the participants as an expert on the topic and guides the learning activities. In addition, the trainer helps create a comfortable learning environment and promotes those activities that assist the participant in acquiring the new knowledge, skills and attitudes. Finally, the training approach used in this course stresses the importance of the cost-effective use of resources and application of relevant educational technologies including use of humane training techniques. The latter encompasses the use of anatomic models, such as the ZOE pelvic model or the Norplant implants training arm, to minimize client risk and facilitate learning. TRAINING APPROACH The mastery learning approach to training assumes that all participants can master (learn) the required knowledge, skills and attitudes, provided there is sufficient time and appropriate training methods are used. The goal of mastery learning is that 100 percent of those being trained will master the knowledge and skills on which the training is based. While some participants are able to acquire new knowledge or a new skill Instructional Design Skills Course Handbook 1

6 immediately, others may require additional time or alternative learning methods before they are able to demonstrate mastery. Not only do people vary in their abilities to absorb new material, but individuals learn best in different ways through written, spoken or visual means. Effective learning strategies, such as mastery learning, take these differences into account and use a variety of teaching methods. The mastery learning approach also enables the participant to have a selfdirected learning experience. This is achieved by having the trainer serve as facilitator and by changing the concept of testing and how test results are used. The philosophy underlying the mastery learning approach is one of continual assessment of participant learning where the trainer regularly informs participants of their progress in learning new information and skills. With the mastery learning approach, assessment of learning is:! Competency-based, which means assessment is keyed to the course objectives and emphasizes acquiring the essential skills and attitudinal concepts needed to perform a job, not just to acquiring new knowledge.! Dynamic, because it enables participants to receive continual feedback on how successful they are in meeting the course objectives.! Less stressful, because from the outset participants, both individually and as a group, know what they are expected to learn, know where to find the information and have ample opportunity for discussion with the trainer. KEY FEATURES OF MASTERY LEARNING Mastery learning is based on principles of adult learning. This means that learning is participatory, relevant and practical. It builds on what the participant already knows or has experienced and provides opportunities for practicing new skills. Other key features of mastery learning are that it:! Uses behavior modeling! Is competency-based! Incorporates humanistic training techniques 2 Instructional Design Skills Course Handbook

7 Behavior Modeling Social learning theory states that when conditions are ideal, a person learns most rapidly and effectively from watching someone perform (model) a skill or activity. For modeling to be successful, however, the trainer must clearly demonstrate the skill or activity so that participants have a clear picture of the performance expected of them. Behavior modeling, or observational learning, takes place in three stages. In the first stage, skill acquisition, the participant sees others perform the procedure and acquires a mental picture of the required steps. Once the mental image is acquired, the participant attempts to perform the procedure, usually with supervision. Next, the participant practices until skill competency is achieved and s/he feels confident performing the procedure. The final stage, skill proficiency, only occurs with repeated practice over time. Skill Acquisition Skill Competency Skill Proficiency Knows the steps and their sequence (if necessary) to perform the required skill or activity but needs assistance Knows the steps and their sequence (if necessary) and can perform the required skill or activity Knows the steps and their sequence (if necessary) and efficiently performs the required skill or activity Competency-Based Training Competency-based training (CBT) is learning by doing. It focuses on the specific knowledge, skills and attitudes needed to carry out a procedure or activity. How the participant performs (i.e., a combination of knowledge, attitudes and most important, skills) is emphasized rather than just what information the participant has learned. Competency in the new skill or activity is assessed objectively by evaluating overall performance. To successfully accomplish CBT, the clinical skill or activity to be taught must be broken down into its essential steps. Each step is then analyzed to determine the most efficient and safe way to perform and learn it. The process is called standardization. Once a procedure, such as IUD insertion, has been standardized, competency-based learning guides and evaluation checklists can be developed to make learning the necessary steps or tasks easier and evaluating the participant s performance more objective. An essential component of CBT is coaching, in which the trainer first explains a skill or activity and then demonstrates it using an anatomic Instructional Design Skills Course Handbook 3

8 model or other training aid, such as a videotape. Once the procedure has been demonstrated and discussed, the trainer/coach then observes and interacts with participants to guide them in learning the skill or activity, monitoring their progress and helping them overcome problems. The coaching process ensures that each participant receives feedback regarding performance:! Before practice The trainer and participant meet briefly before each practice session to review the skill/activity, including the steps/tasks that will be emphasized during the session.! During practice The trainer observes, coaches and provides feedback to the participant as s/he performs the steps/tasks as outlined in the learning guide or, in the case of developing training materials, outlined in the reference manual.! After practice Immediately after practice, the trainer uses the learning guide or training materials to discuss the strengths of the participant s performance and also offers specific suggestions for improvement. Humanistic Training Techniques The use of more humane (humanistic) techniques also contributes to better clinical training. A major component of humanistic training is the use of anatomic models, which closely simulate the human body, and other learning aids. Working with models initially allows participants to learn and practice new skills in a simulated setting rather than with clients. This reduces stress for the learner as well as risk of injury and discomfort to the client. Thus, the effective use of models (humanistic approach) is an important factor in improving the quality of clinical training and, ultimately, service provision. Before a participant performs a clinical procedure with a client, two learning activities should occur:! The clinical trainer should demonstrate the required skills and client interactions several times using an anatomic model and appropriate training videotape.! Under the guidance of the clinical trainer, the participant should practice the required skills and client interactions using the model and actual instruments in a setting that is as similar as possible to the real situation. 4 Instructional Design Skills Course Handbook

9 Only when skill competency and some degree of skill proficiency have been demonstrated should participants have their first contact with a client. When mastery learning, which is based on adult learning principles and behavior modeling, is integrated with CBT, the result is a powerful and extremely effective method for providing clinical training. And when humanistic training techniques, such as using anatomic models and other learning aids, are incorporated, training time and costs can be reduced significantly. COMPONENTS OF THE INSTRUCTIONAL DESIGN SKILLS TRAINING PACKAGE This instructional design skills course is built around use of the following components:! Need-to-know information contained in a reference manual! A course handbook containing validated questionnaires and course design documents! A trainer s notebook including questionnaire answer keys and detailed information about conducting the course The reference manual recommended for use in this course is Instructional Design Skills for Reproductive Health Professionals, which contains practical, how to information and techniques to help the trainer to design, deliver and evaluate training. USING THE INSTRUCTIONAL DESIGN SKILLS TRAINING PACKAGE In designing the training materials for this course, particular attention has been paid to making them user friendly and to permit the course participants and trainer the widest possible latitude in adapting the training to the participants (group and individual) learning needs. For example, at the beginning of the course an assessment is made of each participant s knowledge of instructional design skills. The results of this precourse assessment are then used jointly by the participants and trainer to adapt the course content as needed so that the training focuses on acquisition of new information and skills. A second feature relates to the use of the reference manual and course handbook. The reference manual is designed to provide all of the essential information needed to conduct the course in a logical manner. Instructional Design Skills Course Handbook 5

10 Because it serves as the text for the participants and the reference source for the trainer, special handouts or supplemental materials are not needed. In addition, because the manual contains only information that is consistent with the course goals and objectives, it becomes an integral part of all classroom exercises such as giving an illustrated lecture or providing problem-solving information. The course handbook, on the other hand, serves a dual function. First, and foremost, it is the road map which guides the participant through each phase of the course. It contains the course syllabus and course schedule as well as all supplemental printed materials (precourse questionnaire, individual and group learning matrix and course evaluation) needed during the course. The trainer s notebook contains the same material as the course handbook for participants as well as material for the trainer. This includes the course outline, precourse questionnaire answer key, and the midcourse questionnaire and answer key. In keeping with the training philosophy on which this course is based, all training activities will be conducted in an interactive, participatory manner. To accomplish this requires that the role of the trainer continually change throughout the course. For example, s/he is an instructor when making a classroom presentation; a facilitator when conducting small group discussions or using role plays; and shifts to the role of coach when helping participants practice a skill or activity. Finally, when objectively assessing performance, s/he serves as an evaluator. In summary, the CBT approach used in this course incorporates a number of key features. First, it is based on adult learning principles, which means that it is interactive, relevant and practical. Moreover, it requires that the trainer facilitate the learning experience rather than serve in the more traditional role of an instructor or lecturer. Second, it involves use of behavior modeling to facilitate learning. Third, it is competency-based. This means that evaluation of the participant is based on how well s/he performs the activity, not just how much has been learned. 6 Instructional Design Skills Course Handbook

11 INTRODUCTION COURSE DESIGN This instructional design skills course is designed to help clinical and advanced trainers and those involved in course and materials design become more effective instructional designers. The course builds on each participant s past knowledge and takes advantage of her/his high motivation to accomplish the learning tasks in the minimum time. Training emphasizes doing, not just knowing, and uses competencybased evaluation of performance. An instructional design skills course consists of two components:! Transfer of the knowledge and skills required to assist with needs assessments, design training materials (e.g., learning guides, checklists, case studies, role plays, pre- and midcourse questionnaires), and evaluate training.! Development or revision of a training package or training materials during the course. There is a model course schedule provided in this handbook. The schedule outlines the general sessions of an instructional design skills course which could be applied to any number of situations. This training course differs from traditional courses in several ways, as described below.! During the first day of the course, participants demonstrate their knowledge of instructional design skills by completing a written test (Precourse Questionnaire).! Classroom sessions focus on key aspects of instructional design.! Progress in knowledge-based learning is measured during the course using a standardized written assessment (Midcourse Questionnaire).! Progress in learning instructional design skills, such as developing training materials, is observed and evaluated during the course. Successful completion of the course is based on mastery of both the content and skills components. EVALUATION Instructional Design Skills Course Handbook 7

12 This instructional design skills course is designed to produce competent instructional designers and, in some cases, master trainers. An individual usually attains full qualification as a master trainer through cotraining one or more advanced training skills courses for clinical trainers while being assisted by a master trainer or technical expert. Qualification is a statement by the training organization that the participant has met the requirements of the course in knowledge, skills and practice. Qualification does not imply certification. Personnel can be certified only by an authorized organization or agency. Qualification is based on the participant s achievement in three areas:! Knowledge A score of at least 85% on the Midcourse Questionnaire! Skills Satisfactory performance of instructional design skills! Practice Demonstrated ability to conduct clinical and advanced training skills courses for clinical trainers Responsibility for the participant becoming qualified is shared by the participant and the trainer. The evaluation methods used in the course are described briefly below:! Midcourse Questionnaire. This knowledge assessment will be given at the time in the course when all subject areas have been presented. A score of 85% or more correct indicates knowledgebased mastery of the material presented in the reference manual. For those scoring less than 85% on their first attempt, the trainer should review the results with the participant individually and guide her/him on using the reference manual to learn the required information. Participants scoring less than 85% can take the Midcourse Questionnaire again at any time during the remainder of the course.! Skills. Satisfactory performance of training materials development skills assessed during the course.! Practice. For candidate master trainers, demonstrated ability to conduct an advanced training skills course for clinical trainers. Following the instructional design skills course, each candidate master trainer will be provided the opportunity to conduct training while being assisted (and evaluated) by a master trainer or technical expert until s/he becomes proficient and thus qualified as a master trainer. 8 Instructional Design Skills Course Handbook

14 Training/Learning Methods! Illustrated lectures and group discussions! Individual and group exercises! Role plays! Guided practice activities developing training materials with feedback from participants and trainers Training Materials. This course handbook is designed to be used with the following materials:! Reference manual: Instructional Design Skills for Reproductive Health Professionals (JHPIEGO)! Clinical skills package (reference manual, course handbook for participants and course notebook for trainers)! Anatomic models (e.g., pelvic and hand-held uterine, Norplant implants training arm) if needed! Annotated training slide sets (e.g., IUD, Norplant implants, infection prevention) if needed Participant Selection Criteria Participants for this course should be clinical and advanced trainers (physicians, nurses or midwives) who are proficient in providing one or more clinical contraceptive methods and have experience training service providers and clinical trainers. Note: In some situations the participants may include individuals who are responsible for conducting needs assessments, developing training materials and evaluating training, but who are not clinical trainers. Methods of Evaluation Participant! Pre- and Midcourse Questionnaires! Evaluation of participant-developed materials Course! Course Evaluation (to be completed by participants) 10 Instructional Design Skills Course Handbook

18 PRECOURSE QUESTIONNAIRE HOW THE RESULTS WILL BE USED The main objective of the Precourse Questionnaire is to assist both the trainer and the participant as they begin their work together in the course by assessing what the participants, individually and as a group, know about the course topic. This allows the trainer to identify topics that may need additional emphasis during the course. Providing the results of the precourse assessment to the participants enables them to focus on their individual learning needs. In addition, the questions alert participants to the content that will be presented in the course. The questions are presented in the TRUE-FALSE format. A special form, the Individual and Group Assessment Matrix, is provided to record the scores of all course participants. Using this form, the trainer and participants can quickly chart the number of correct answers for each of the 51 questions. By examining the data in the matrix, the group can easily determine their collective strengths and weaknesses and jointly plan with the trainer how best to use the course time to achieve the desired learning objectives. For the trainer, the questionnaire results will identify particular topics which may need additional emphasis during the learning sessions. Conversely, for those categories where 70% or more of participants answer the questions correctly, the trainer may elect to use some of the allotted time for other purposes. For example, if the participants as a group did well (70% or more correct) in answering the questions in the category Designing a Training Course (questions 20 through 26), the trainer may elect to assign Chapter 5, Designing a Training Course from the Instructional Design Skills reference manual as homework rather than discussing these topics in class. For the participants, the learning objective(s) related to each question and the corresponding chapter(s) in the reference manual are noted beside the answer column. To make the best use of the limited course time, participants are encouraged to address their individual learning needs by studying the designated chapter(s). 14 Instructional Design Skills Course Handbook

19 PRECOURSE QUESTIONNAIRE/ANSWER SHEET Instructions: In the space provided, print a capital T if the statement is true or a capital F if the statement is false. AN APPROACH TO CLINICAL TRAINING 1. The focus of training is on immediate use on the job, whereas the focus of education is on future applications. 2. The mastery learning approach assumes that 85% of the participants can master the required knowledge and skills, provided sufficient time and appropriate methods are used. 3. Learning is more effective when it builds on areas where the participants have no previous knowledge or experience. 4. Skill competency means that the participant knows the steps and their sequence (if necessary) to perform the required skill or activity but needs assistance. 5. Coaching involves positive feedback, active listening, questioning and the use of problemsolving skills. 6. The role of the clinical trainer is to facilitate learning. 7. In selecting potential trainers, one must look for people with a genuine interest in training. Participant Objective 1 (Chapter 1) Participant Objective 1 (Chapter 1) Participant Objective 1 (Chapter 1) Participant Objective 1 (Chapter 1) Participant Objective 1 (Chapter 1) Participant Objective 1 (Chapter 1) Participant Objective 1 (Chapter 1) INSTRUCTIONAL DESIGN PROCESS 8. The first phase of the instructional design process is design. 9. The course outline is created during the design phase. Participant Objective 2 (Chapter 2) Participant Objective 2 (Chapter 2) 10. Trainer s notes are created during the development phase. 11. In a comprehensive clinical training package, the course syllabus is found in the trainer s notebook. Participant Objective 2 (Chapter 2) Participant Objective 2 (Chapter 2) Instructional Design Skills Course Handbook 15

20 ASSESSING TRAINING NEEDS 12. A training sector assessment documents the adequacy of a specific training or educational institution to conduct quality reproductive health/family planning (RH/FP) training. 13. Documenting the adequacy of a school of midwifery to conduct quality RH/FP training is referred to as an institutional needs assessment. 14. Documenting the adequacy of a specific site to offer quality RH/FP services, and potentially quality clinical training, is referred to as a facility needs assessment. 15. A training event needs assessment takes place once the course has started. 16. Needs assessments are to be completed prior to training, because once training begins it is too late to assess needs. Participant Objective 3 (Chapter 3) Participant Objective 3 (Chapter 3) Participant Objective 3 (Chapter 3) Participant Objective 3 (Chapter 3) Participant Objective 3 (Chapter 3) INSTRUCTIONAL CONTENT ANALYSIS 17. One way of identifying the information to be taught in a course is to review an existing textbook or reference manual. 18. One approach for identifying the steps within a psychomotor task or skill is to conduct a task analysis. 19. The attitude area of learning is referred to as the cognitive learning domain. Participant Objective 4 (Chapter 4) Participant Objective 4 (Chapter 4) Participant Objective 4 (Chapter 4) DESIGNING A TRAINING COURSE 20. The course syllabus provides a summary of daily activities for the course. 21. An enabling objective is a training-related objective that supports a primary objective. 22. Practice activities consist of practice and feedback elements. Participant Objective 5 (Chapter 5) Participant Objective 5 (Chapter 5) Participant Objective 5 (Chapter 5) 23. Training methods are selected once training begins. Participant Objective 5 (Chapter 5) 16 Instructional Design Skills Course Handbook

Instructional Design Skills for Reproductive Health Professionals Course Notebook for Trainers Presentation graphics summarizing the key points related to this topic are now available on ReproLine at www.reproline.jhu.edu.

JHPIEGO, an affiliate of The Johns Hopkins University, builds global and local partnerships to enhance the quality of health care services for women and families around the world. JHPIEGO is a global leader

JHPIEGO, an affiliate of The Johns Hopkins University, builds global and local partnerships to enhance the quality of health care services for women and families around the world. JHPIEGO is a global leader

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